ASHINGTON - One of the most dramatic moments of Al Gore's speech at the Democratic National Convention arose
when he assailed HMOs, insurance companies, and pharmaceutical firms. He even cited the case of a family that had been told to consider putting a sick child up for adoption because insurers would not pay for treatment.
But Gore's populist attack may have left his running mate, Senator Joseph I. Lieberman, more than a little uncomfortable.
Lieberman has accepted more campaign money from insurance companies in the current election cycle than any other senator, and has taken the third-highest amount of drug company contributions, according to the Center for Responsive Politics.
Aetna, the insurance company responsible for the sick child's coverage, is based in the senator's home state of Connecticut. And Lieberman's wife, Hadassah, worked in the early 1980s as director of policy planning for one of the biggest pharmaceutical firms, Pfizer.
As the campaign proceeds, Gore may try to make a point of Republican presidential candidate George W. Bush's support from various industries. But because of Lieberman's fund-raising record, the Bush campaign would have some grounds for a counterattack.
Gore campaign aides said there is no real disagreement between Gore and Lieberman on the health insurance and pharmaceutical companies, at least not any longer. While Lieberman's ties with Connecticut's top industries had led him to urge compromise with the insurance companies, the senator now is in agreement with Gore's populist attacks, campaign aides said.
''The bottom line is that Al and Joe are both pushing for a real prescription-drug benefit opposed by the drug industry and a real patients' bill of rights opposed by insurance industry,'' said a Gore spokesman, Doug Hattaway.
Lieberman's close ties to the insurance and health industries are especially striking when Gore's and Bush's campaign contributions are contrasted. Nearly all of the industries that Gore has attacked have contributed relatively little to his campaign, while they have poured money into the coffers of Bush.
For example, the insurance industry has contributed nearly $1.5 million to Bush while giving around $300,000 to Gore, and health professionals have given $2.5 million to Bush compared with $610,000 to Gore.
Similarly, the oil and gas industry has given $1.6 million to Bush while providing only $104,000 to Gore, and the auto industry has given $1.1 million to Bush and just $90,000 to Gore, according to the Center for Responsive Politics, a group that researches the ties between money and campaigns.
But Lieberman is another story. A self-described ''probusiness Democrat'' whose state is known as the insurance capital of America, Lieberman has tended to be more accommodating toward the health and insurance industries than Gore has. For example, Lieberman was no fan of the health care coverage proposal put forward by President Clinton in 1993. Instead, he called it ''a top-down, big welfare-state kind of program.'' The proposal eventually died in Congress.
A Lieberman spokesman, Dan Gerstein, acknowledged that the senator had opposed the Clinton health bill and often worked to help the insurance industry in his state. But Gerstein added that Lieberman also fought the insurance industry over the years, including an antitrust suit that Lieberman filed when he was the state's attorney general.
''I don't think Senator Lieberman is ashamed in any way for helping one of the biggest constituents in his state that provides thousands of jobs to people in Connecticut,'' Gerstein said. ''He would be remiss in his duties as senator not to be sensitive to the interests of a major employer in his state.''
But some of those interests are now at odds with the Gore-Lieberman campaign theme. Gore's convention speech took on various industries, as he assailed ''big tobacco, big oil, the big polluters, the pharmaceutical companies, the HMOs.''
Gore's broadsides against health insurance and drug companies were particularly striking because they are similar to the way President Clinton and Hillary Rodham Clinton attacked those industries in 1993. At the time, the Clintons hoped their campaign would lay the groundwork for passing their health-care bill, but they wound up galvanizing the industries to spend tens of millions of dollars to kill the measure. The president eventually said he ''bit off more than I could chew'' in urging passage of such a sweeping bill.
Gore has a narrower set of goals. His criticisms of health maintenance organizations, for example, are aimed at winning passage of a patients' bill of rights.
Gore dramatized his point by telling the story of Ian Malone, who the vice president said suffered a medical mistake at birth and needed costly treatment. ''Their HMO had told the Malones it would no longer pay for the nurse they needed, and then told them they should consider giving Ian up for adoption,'' Gore said.
Gore did not identify the HMO, but Connecticut-based Aetna has acknowledged being the parent company. An Aetna spokeswoman, Jill Griffiths, denied that the HMO had made any suggestion about adoption. ''Based on discussions with the nurses and case managers who have been involved in this case, we have absolutely no knowledge of any statement being made suggesting adoption, which would be totally against our policy,'' Griffiths said.
But Ian's father, Dylan Malone, said in a telephone interview from Everett, Wash., that an Aetna representative did say in a ''delicate'' way that ''if you surrender your custodial rights, the state would step in.''
Malone said he was an unpaid volunteer in Gore's 1988 presidential bid and became involved in this year's campaign after Gore successfully put pressure on Aetna to pay for Ian's care.
Malone, asked if he had any concern about Lieberman's ties to the insurance industry, responded: ''I admire the vice president because he can choose someone who is not lock-step with him on every issue.'' He also expressed gratitude that Lieberman has supported a version of the patients' bill of rights that would enable an independent review of decisions made by HMOs.
For years, Gore has had mixed feelings about the drug companies. For instance, Gore successfully advocated more spending on research and development that helped drug firms, especially through increased funding for the National Institutes of Health. But Gore also became convinced the industry is more interested in high profits instead of lower-cost drugs that would be more widely distributed.
''Both the vice president and Senator Lieberman have been a good friend of the pharmaceutical industry over the years,'' said Judith H. Bello, executive vice president of the Pharmaceutical Research and Manufacturers of America, a 100-company industry group. ''They have supported better funding for basic research, modernization of the Food and Drug Administration.''
But for the past year, many companies belonging to the trade group have been financing a television ad campaign aimed at defeating the Clinton administration's current plan to extend Medicare coverage to prescription drugs, which nearly mirrors Gore's proposal.
In the ad campaign, a group called ''Citizens for Better Medicare'' revives the successful strategy used in 1993 against the Clinton health proposal, saying the drug plan would put big government in everyone's medicine chest.
Despite the grass-roots-sounding name of the group, the ads, costing millions of dollars, are paid for mostly by the drug industry. ''Almost all of the money comes from pharmaceutical companies,'' said a spokesman for the group, Dan Zielinski. ''A very small amount comes from citizens.''
Gore wants to use some of the budget surplus to expand Medicare to include prescription coverage, with the government paying half the cost of drugs up to $5,000 per year per person. Gore says that would provide tens of billions of dollars in new sales for a drug industry that is already highly profitable.
The pharmaceutical industry argues that the Gore plan could lead to price controls on many prescriptions and could limit research and development of new drugs. Gore, however, said his proposal would ensure that senior citizens and people with disabilities could afford prescription drugs.
The industry, as well as Bush, prefers a plan that would rely on more competition among insurance companies.
